How to diagnose acute appendicitis: ultrasound first
| Autor: | Michel Claudon, Gerhard Mostbeck, Dirk-André Clevert, Michael Bachmann Nielsen, E. Jane Adam, Catherine M. Owens, Christiane M. Nyhsen, Carlos Nicolau |
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| Přispěvatelé: | UL, IADI, Wilhelminenspital Vienna = Wilhelminen Hospital, St George's Hospital NHS Healthcare Trust, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Radiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), University-Hospital Munich-Großhadern [München], University of Barcelona, Hospital Clinic Barcelona, City Hospitals Sunderland NHS Foundation Trust, Great Ormond Street Hospital for Children [London] (GOSH), Wilhelminenspital Vienna, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Opinion Perforation (oil well) Diagnostic algorithm 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Magnetic resonance imaging Ultrasound medicine Radiology Nuclear Medicine and imaging Computed tomography Neuroradiology [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Interventional radiology medicine.disease Appendicitis Appendix 3. Good health medicine.anatomical_structure Acute appendicitis Radiology business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Insights into Imaging Insights into Imaging, Springer, 2016, 7 (2), pp.255-263. ⟨10.1007/s13244-016-0469-6⟩ |
| ISSN: | 1869-4101 |
| Popis: | Acute appendicitis (AA) is a common abdominal emergency with a lifetime prevalence of about 7 %. As the clinical diagnosis of AA remains a challenge to emergency physicians and surgeons, imaging modalities have gained major importance in the diagnostic work-up of patients with suspected AA in order to keep both the negative appendectomy rate and the perforation rate low. Introduced in 1986, graded-compression ultrasound (US) has well-established direct and indirect signs for diagnosing AA. In our opinion, US should be the first-line imaging modality, as graded-compression US has excellent specificity both in the paediatric and adult patient populations. As US sensitivity is limited, and non-diagnostic US examinations with non-visualization of the appendix are more a rule than an exception, diagnostic strategies and algorithms after non-diagnostic US should focus on clinical reassessment and complementary imaging with MRI/CT if indicated. Accordingly, both ionizing radiation to our patients and cost of pre-therapeutic diagnosis of AA will be low, with low negative appendectomy and perforation rates. Main Messages • Ultrasound (US) should be the first imaging modality for diagnosing acute appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear. |
| Databáze: | OpenAIRE |
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